A largely unproven treatment appears to help some people with fibromyalgia pain. Find out about this controversial approach.

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We're not talking about a fruity drink with a cherry and an umbrella. Many people who are living with fibromyalgia swear by the Myers cocktail, an intensive vitamin and mineral dose delivered once a week intravenously. Both patients and practitioners report that this infusion - named for John Myers, MD, the Baltimore doctor who first experimented with a vitamin and mineral mix of magnesium, calcium, B vitamins, and vitamin C - helps ease fibromyalgia pain and other symptoms, such as profound fatigue.

According to fibromyalgia researcher David Katz, MD, founding director of the Prevention Research Center at Yale University in Derby, Conn, about 12,000 people across the United States are treated with the Myers cocktail, and about four out of five say the treatment helps ease fibromyalgia symptoms. The treatment is considered to be a form of complementary and alternative medicine (CAM), not traditional treatment, which includes prescribed medications. However, people often are willing to try novel approaches because living with fibromyalgia is often challenging and fibromyalgia symptoms can be so persistent.

Myers Cocktail 101

The Myers cocktail contains a variety of nutrients:

5 milliliters (mL) magnesium chloride hexahydrate

3 mL calcium gluconate

1 mL hydroxocobalamin

1 mL pyridoxine hydrochloride

1 mL dexpanthenol

1 mL B-complex (thiamine, riboflavin, niacinamide) vitamins

5 mL vitamin C

Because some people can have an allergic reaction to thiamine, says Dr. Katz, his clinic performs a skin test before administering the cocktail and takes out thiamine if there is an allergic response.

Usually the cocktail is given once a week. Katz recommends administering it once a week for eight weeks, followed by a break to see if symptoms remain improved.

"I've been running an integrative medicine center since 2000," says Katz. "We specialize in the hard-to-treat. We had a disproportional number of folks with conditions like fibromyalgia. I was frustrated by our inability to make them better." He directed a small pilot study to find out if the Myers cocktail was as effective as, or more so than, an intravenous placebo treatment given to people living with fibromyalgia. The results, published in the Journal of Alternative and Complementary Medicine, showed improvement in both groups with slightly better results in those who received the Myers cocktail . The difference in improvement between those in the Myers cocktail group and those receiving the placebo was not statistically significant, however. Katz acknowledges that, in general, the placebo effect is notoriously strong and often becomes more pronounced as interventions become more sophisticated - intravenous placebos tend to have an even stronger positive effect than placebo pills.

These results, the only scientific look at the effects of the Myers cocktail, are not enough to conclusively say that the intravenous infusion improves fibromyalgia symptoms. However, Katz says that for people who want it and who might feel better afterwards, there are no known side effects, toxicity, or drawbacks to trying it.

Why Myers Cocktail Might Work

"We don't know what the mechanism of the Myers cocktail is," observes Katz, who would like to see more research done on the therapy. Thousands of people use it, and without more information, he says, its use remains an uncontrolled experiment. Nevertheless, Katz has a few theories about why it might be effective in managing certain fibromyalgia symptoms, such as pain and fatigue:

B vitamins: "B vitamins are important for nerve cells," Katz notes, "and it may be that when you rapidly bump up B vitamins, you help stabilize nerve conduction." This could be how the treatment helps ease fibromyalgia pain.

Minerals: Katz explains that the pain often described by people with fibromyalgia is similar to the pain caused by very rigorous exercise, such as cramps that occur when muscles don't get enough oxygen and lactic acid levels rise. The Myers cocktail contains both magnesium and calcium, which Katz argues may help blood vessels to dilate and carry more oxygen, helping muscles to relax.

Despite the lack of clarity on how the Myers' cocktail works, Katz says that "we use the Myers routinely - we have patients who swear by it." He also recommends a multi-faceted approach to treating fibromyalgia, including:

Prescription medications. For people who want them and find them effective, appropriate treatments do exist.

Arginine. Katz recommends a gram and a half twice a day of arginine, an amino acid precursor to nitric oxide that helps to open blood vessels and may promote improved blood flow. "Try that for several weeks," he advises.

Massage. Massage can help both muscles and nerves. "Find someone who is good at what they do and can adjust the strength and intensity to accommodate the soreness," Katz says.

Acupuncture. This eastern medicine approach has been shown to ease tension and pain.

Psychotherapy. Many people with fibromyalgia have mood disorders, stress, and anxiety occurring along with or because of fibromyalgia. Therapy can be a good idea, notes Katz.

Sleep. "Fibromyalgia has a tendency to sabotage sleep, and lack of sleep lowers pain thresholds," Katz explains. It's a good idea to improve sleep hygiene so you can get a good night's rest.

Fibromyalgia continues to be a mysterious condition, and much more research needs to be done, says Katz. The Myers cocktail plays a role for some people, as do many other therapies - and, he points out, "if you can improve using each of these, the net effect can be quite dramatic."

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